Bovine arch anatomy influences recoarctation rates in the era of the extended end-to-end anastomosis

Turek, Joseph W.; Conway, Brian D.; Cavanaugh, Nicholas B.; Meyer, Alex M; Aldoss, Osamah; Reinking, Benjamin E.; Elhattab, Ahmed; Rossi, Nicholas P.

doi:10.1016/j.jtcvs.2017.10.055

Cited by 27 publications

(21 citation statements)

References 18 publications

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“…There have been several studies evaluating risk factors for adverse outcomes after surgical intervention, including recoarctation, although the literature is often conflicting and inconclusive, especially regarding the influence of child weight and surgical strategy on the rate of reinterventions [7,8,13,14]. Other possible risk factors identified in individual studies include anatomical and morphological characteristics of the aortic arch, preoperative care, and age at time of the intervention [12,14,15]. Nevertheless, a comprehensive analysis of the evidence to determine the risk factors conclusively lacks in the literature.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Recoarctation and Mortality in Infants Submitted to Aortic Coarctation Repair: A Systematic Review

et al. 2020

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abaixo assinado, nº mecanográfico 201405204, estudante do 6º ano do Ciclo de Estudos Integrado em Medicina, na Faculdade de Medicina da Universidade do Porto, declaro ter atuado com absoluta integridade na elaboração deste projeto de opção.Neste sentido, confirmo que NÃO incorri em plágio (ato pelo qual um indivíduo, mesmo por omissão, assume a autoria de um determinado trabalho intelectual, ou partes dele). Mais declaro que todas as frases que retirei de trabalhos anteriores pertencentes a outros autores, foram referenciadas, ou redigidas com novas palavras, tendo colocado, neste caso, a citação da fonte bibliográfica.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Recoarctation and Mortality in Infants Submitted to Aortic Coarctation Repair: A Systematic Review

et al. 2020

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“…[4][5][6]8,[10][11][12][13]16 The results of our analysis of indicated that bovine arch is not associated with fetal anomalies, although we appreciate that our study was underpowered. The bovine arch pattern has been described in the pediatric literature as associated with coarctation of the aorta, 19 and higher rates of prevalence have been reported in pediatric populations with congenital disease (17.6% among patients with aortic coarctation compared to 15.2% in the entire population studied). 20 The low percentage of congenital heart disease in our study population made the sample underpowered to assess such a relationship.…”

Section: Discussionmentioning

confidence: 95%

Bovine aortic arch: Prevalence in human fetuses

Goldsher

Salem

Weisz

et al. 2019

J of Clinical Ultrasound

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Objective “Bovine aortic arch” is the second most common variant of aortic arch branching, in which only two branches originate directly from the aorta. The prevalence of this condition has been reported in different studies to be around 6% in human fetuses and 11‐27% in the adult population. In this study, we describe the prevalence of bovine aortic arch in fetuses, and assess the prevalence of concomitant fetal anomalies. Methods A retrospective analysis of 417 fetuses between 15‐40 weeks of gestation. Data regarding branching of the fetal aortic arch and other fetal anomalies were collected by fetal echocardiography and/or fetal ultrasonography. Results A bovine arch was found in 20/413 fetuses (4.8%, 95CI 3.1‐7.3%), of whom 14/310 (4.5%) had no fetal anomalies, and 6/77 (7.8%) exhibited minor changes (P = .241). None of the 26 fetuses with major anomalies had a bovine arch. Conclusion Fetuses in this study had a lower prevalence of bovine aortic arch than that previously reported in adults, most probably due to differences in the population examined. This study was underpowered to determine that bovine arch is a common anatomic variant, and is not associated with fetal anomalies.

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“…While we did not include presence of bovine arch, or measures between brachiocephalic vessels in our analysis, Turek et al noted that these are important predictive factors for reintervention; 28.6% of their patients with a bovine arch had a postoperative gradient of 20 mm Hg or greater. 15 We plan to incorporate this as well as other arch characteristics in our future study.…”

Section: Commentmentioning

confidence: 99%

Proximal Arch in Left Thoracotomy Repair of Neonatal and Infant Coarctation—How Small Is Too Small?

Callahan

Saudek

Creighton

et al. 2019

World J Pediatr Congenit Heart Surg

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Background: We sought to evaluate the relationship between proximal arch hypoplasia and reintervention for left thoracotomy repair of coarctation of the aorta. Methods: This was a retrospective review of 153 consecutive neonates and infants undergoing left thoracotomy and extended end-to-end repair of coarctation from January 1, 2000, to January 1, 2014, at a single center with exclusion of single ventricle–palliated patients. Primary outcome was reintervention evaluated with respect to five definitions of proximal arch hypoplasia. Results: Median follow-up was 7.2 years. Reintervention occurred in eight (5.2%) patients, with 50% of patients undergoing re-intervention in the first six months after their index operation. Using Kaplan-Meier analysis and log-rank test, with hypoplasia defined by weight, hypoplasia was not associated with increased reintervention for arch size < patient weight (in kilograms; P = .24) or for arch size < patient weight (in kilograms) +1 ( P = .02, higher freedom from reintervention in hypoplasia group). For each of the five comparison groups, freedom from reintervention was similar between the groups with and without proximal arch hypoplasia: (1) z-score < −2 versus ≥−2 ( P = .72), (2) z-score < −3 versus ≥−3 ( P = .95), and (3) z-score < −4 versus ≥−4 ( P = .17). Conclusion: In our cohort of patients with left thoracotomy and extended end-to-end repair of coarctation, proximal arch hypoplasia, defined by various weight-based or z-score thresholds, was not associated with reintervention. While this may imply value to a more liberal use of thoracotomy, confirmation requires longer term follow-up with a more comprehensive evaluation of the patients and their arches.

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Bovine arch anatomy influences recoarctation rates in the era of the extended end-to-end anastomosis

Cited by 27 publications

References 18 publications

Risk Factors for Recoarctation and Mortality in Infants Submitted to Aortic Coarctation Repair: A Systematic Review

Risk Factors for Recoarctation and Mortality in Infants Submitted to Aortic Coarctation Repair: A Systematic Review

Bovine aortic arch: Prevalence in human fetuses

Proximal Arch in Left Thoracotomy Repair of Neonatal and Infant Coarctation—How Small Is Too Small?

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